2017 Physician Workforce Annual Report€¦ · The 2018 Physician Workforce Annual Report presents a summary and analysis of the 2017 and 2018 Physician Workforce Surveys.1 Physicians

2018 Physician Workforce Annual Report ____________________________________________________________________________

November 2018

Rick Scott Governor

Celeste Philip, MD, MPH Surgeon General and Secretary of Health

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Table of Contents

Key Definitions ............................................................................................................................ ii

Executive Summary ................................................................................................................... iii

Introduction ................................................................................................................................ 4

Physician Workforce Advisory Council ....................................................................................... 5

Physician Workforce Demographics ........................................................................................... 7

Gender ................................................................................................................................... 7

Ethnicity ................................................................................................................................. 8

Age .......................................................................................................................................10

Physician Workforce Practice Characteristics ...........................................................................13

Primary Specialty ..................................................................................................................13

Practice Setting .....................................................................................................................15

Practice Hours ......................................................................................................................18

Medicare Patients .................................................................................................................20

Medicaid Patients ..................................................................................................................21

Retirement ............................................................................................................................23

Relocation .............................................................................................................................24

Changing Specialty ...............................................................................................................27

Obstetrics and Gynecology Specialty Questions ...................................................................29

Radiology Specialty Questions ..............................................................................................31

Physicians Not Actively Practicing in Florida .............................................................................34

Department Programs to Support Physician Workforce Development .......................................36

Summary of 2017 Recommendations and 2018 Updates .........................................................37

Conclusion ................................................................................................................................41

Appendix A: Physician Workforce per Capita by County, 2017–2018 ........................................42

Appendix B: Change in Practicing Physicians by County ..........................................................43

Appendix C: Specialty Group Counts by County, 2017–2018....................................................47

Appendix D: Physicians Planning to Retire in the Next Five Years ............................................49

Appendix E: List of Survey Specialty and Subspecialty Codes ..................................................50

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Key Definitions

Medical Specialist: Physicians indicating that they practice a specialized or subspecialized

branch of medicine. This includes internal medicine subspecialties (0502-0522), medical

genetics (0600-0605), neurology (0700-0710), nuclear medicine (0800-0804), ophthalmology

(1100), orthopedic medicine (1100-1103), otolaryngology (1200-1205), pathology (1300-1312),

physical medicine & rehabilitation (1500-1506), preventive medicine (1600-1607), proctology

(1700), and urology (2100-2101).

Physicians Not Actively Practicing in Florida: Physicians holding a Florida medical license

who took the survey and indicated that they did not practice medicine in Florida during the

twelve months prior to taking the survey, physicians with inactive licenses, physicians whose

primary practice location is not in Florida (based on county and ZIP code responses), and

physicians whose license status as of May 31, 2018, does not authorize them to practice

(administrative suspension, delinquent, emergency suspension, military active, retired,

suspended, temporary military active, and voluntary withdrawal).

Physician Workforce Survey: The survey completed by all medical doctors (allopathic and

osteopathic) biennially during the Florida medical license renewal process.

Physicians Actively Practicing in Florida: Physicians who are actively practicing medicine in

Florida, have a valid practice address in a Florida county, possess a valid license in active

status, and are not classified as a current medical resident, intern, or fellow.

Primary Care Physicians: Physicians indicating that they practice general internal medicine

(0500-0501), family medicine (0400-0406), or pediatrics (1400-1427) as a primary practice

specialty, as defined by the American Academy of Family Physicians.

Primary Specialty: The primary practice specialty reported by the physician.

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Executive Summary

The 2018 Physician Workforce Annual Report presents a summary and analysis of the 2017 and

2018 Physician Workforce Surveys.1 Physicians are required to complete the survey every two

years when they renew their license to practice; two years of survey responses represent the

majority of physicians in the state of Florida.2 This report helps policymakers make informed

decisions and policies about Florida’s current and future physician workforce and access to care.

A total of 78,018 physicians possess a license that allows them to practice in Florida. Of these

physicians, 70,159 renewed their medical license during 2017 and 2018 and responded to the

workforce survey. Of the physicians renewing their medical license, 51,582 (73.5%) were

practicing in Florida; survey results presented in this report are based on these physicians,

unless otherwise specified.

• Nearly two-thirds (60.3% or 31,076) of physicians are age 50 and older (page 10).

• The top three specialty groups for physicians in Florida are internal medicine (28.6% or

14,232), family medicine (14.5% or 7,236), and pediatrics (7.6% or 3,802) (page 12).

• Primary care physicians account for 36.9% of the physician workforce (page 13).

• More than half (58.2% or 30,002) of physicians work in an office practice setting, and

27.9% (14,371) practice in a hospital (page 15).

• More physicians are accepting new Medicare patients (81.2%) compared to physicians

accepting new Medicaid patients (62.5%) (pages 19–21).

• A total of 16.6% (8,572) of physicians plan to retire in the next five years (page 22).

• There are generally more physicians per capita in areas with large population centers

(Appendix A).

• During the last ten-year period, the total number of physicians licensed in Florida

increased 38.8%, the number of physicians actively practicing in Florida increased

36.2%, and the total population of Florida increased 13.7% (page 41).

• Both the number and percentage of female physicians is increasing. For physicians

under age 40, the percentage of female physicians is almost half (48.7%) (pages 8–12).

• The percentage of minority physicians has been steadily increasing since 2008 (page 9).

1 The 2017–2018 biennial survey cycle is from June 1, 2016 through May 31, 2018. 2 Newly licensed physicians do not complete a survey.

2018 Physician Workforce Annual Report November 2018

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2017 Florida Physician Workforce Annual Report

Introduction

The 2018 Physician Workforce Annual Report is based on responses to the Florida Physician

Workforce Survey. The survey is part of the licensure renewal process for physicians and is

administered by the Florida Department of Health’s (the Department) Division of Medical Quality

Assurance. Physicians must renew their license every other year. This includes allopathic

physicians (M.D.) and osteopathic physicians (D.O.). Newly licensed physicians are not

included in the analysis, because the survey is only administered upon licensure renewal.3

A total of 78,018 physicians possess a license that allows them to practice in Florida. Of these

physicians, 70,159 renewed their medical license during 2017 and 2018 and responded to the

workforce survey. Of those surveyed, 51,582 are actively practicing medicine in Florida. Unless

otherwise noted, this report presents survey results and analyzes this group of physicians. From

the 2012–2013 survey cohort to the 2017–2018 survey cohort, the number of actively practicing

physicians increased 19%, from 43,406 to 51,582.4 During this same time, the population of

Florida increased 8.5%, from 19.3 million to 21.0 million.5

3 In 2017, the licensure renewal survey data storage platform transitioned to a new platform. Although the survey

content remained consistent, the survey response options in the new platform were different from the response options in the old platform. Approximately half of the surveys were completed using the new platform. To ensure the data remained accurate, the Department converted the responses from the old platform to the new platform, and the integrated results are presented in this report. In addition, while the Department’s Division of Medical Quality Assurance reports a 3.8% increase in the number of new licenses issued, the number of physicians who completed the survey online increased 9.5%.

4 In addition, four counties—Hamilton, Hardee, Madison, and Washington—have experienced at least a 30% decrease in the number of practicing physicians. See Appendix B for information on changes in the number and percentages of practicing physicians by county.

5 The 2017 Florida population number is published on the United States Census Bureau’s QuickFacts webpage (www.census.gov/quickfacts/fact/table/fl/PST045217).

http://www.census.gov/quickfacts/fact/table/fl/PST045217


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Physician Workforce Advisory Council

The Physician Workforce Advisory Council (the Council) is established in Section 381.4018,

Florida Statutes, and is charged with advising the State Surgeon General and the Department

about the current and future physician workforce needs in the state. As shown in the table

below, the Council comprises of medical and academic stakeholders, and serves as a

coordinating and strategic planning body to assess the state's physician workforce needs.

Physician Workforce Advisory Council Membership

Council Member Name

State Surgeon General & Secretary – Council Chair Celeste Philip, MD, MPH

An individual recommended by the Florida Alliance for Health Professions Diversity – Council Vice Chair

Alma Littles, MD

A designee from the Department who is a physician licensed under chapter 458 or chapter 459 and recommended by the State Surgeon General.

Kevin Sherin, MD, MPH, MBA

An individual who is affiliated with the Science Students Together Reaching Instructional Diversity and Excellence program and recommended by the area health education center network.

Thesla Berne-Anderson, MS

An individual recommended by the Council of Florida Medical School Deans representing a college of allopathic medicine.

James O’Leary, MD, FACS

An individual recommended by the Council of Florida Medical School Deans representing a college of osteopathic medicine.

James T. Howell, MD, MPH

One individual recommended by the Florida Hospital Association, representing a hospital that is licensed under chapter 395, has an accredited graduate medical education program and is not a statutory teaching hospital.

Saima Chaudhry, MD

One individual representing a statutory teaching hospital as defined in s. 408.07 and recommended by the Safety Net Hospital Alliance.

Edward Jimenez, MBA

An individual recommended by the Florida Medical Association representing a primary care specialty.

Sergio Seoane, MD

An individual recommended by the Florida Medical Association representing a nonprimary care specialty.

Ralph Nobo, MD

An individual recommended by the Florida Osteopathic Medical Association representing a primary care specialty.

Linda Delo, DO

An individual recommended by the Florida Osteopathic Medical Association representing a nonprimary care specialty.

Brett Scotch, DO

An individual who is a program director of an accredited graduate medical education program, representing a program accredited by the Accreditation Council for Graduate Medical Education.

Gary Goforth, MD

An individual who is a program director of an accredited graduate medical education program representing a program that is accredited by the American Osteopathic Association.

Mark Gabay, DO

An individual recommended by the Florida Association of Community Health Centers representing a federally qualified health center located in a rural area as defined in s. 381.0406(2)(a).

Michael Gervasi, DO


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Council Member Name

An individual recommended by the Florida Academy of Family Physicians.

Dennis Saver, MD

The Chancellor of the State University System or his or her designee.

Emily Sikes

A layperson member as determined by the State Surgeon General. Michael Curtis, MBA

The Council has recently focused on making revisions to the Physician Licensure Survey to

capture additional relevant information to assess the Florida physician workforce and advise

policymakers. The Physician Licensure Survey supplies data for the Physician Workforce

Annual Report. The Council recommended revisions to the survey to capture information that

will enhance the Council’s ability to assess future workforce needs and identify gaps and trends.

The Council approved revisions and recommended that the Department initiate the rule revision

process to update the survey. The Department conducted a field test of the revised questions

and oversaw the rule revision process to incorporate the new survey questions.

The Council continues to monitor the status of Graduation Medical Education programs in

Florida. Graduate Medical Education and residency programs are an important component of

Florida’s physician workforce. In 2013, the Florida Legislature created the Statewide Medicaid

Residency Program and appropriated $80 million in recurring state and matching federal funds

to the program. In 2015, the Legislature also created the Graduate Medical Education Startup

Bonus Program to provide resources for educating and training physicians in specialties which

are in a statewide supply-and-demand deficit and appropriated $100 million to the program. The

2018 Legislature appropriated a total of $242.3 million to these programs.


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Physician Workforce Demographics

Gender

As shown in Figure 1, based on the 2017–2018 survey cohort, approximately 30% of Florida’s

actively practicing physicians are female, which is a 74% increase from 2008–2009.

The gender ratio of actively practicing physicians in Florida is approaching the state population

average. In April 2010, the U.S. Census Bureau reported that Florida’s population was 51.1%

female, which is the same percentage for its 2017 estimated population.6 The male-to-female

ratio of physicians in the 2008–2009 survey cohort was 3.3:1; the ratio for the 2017–2018 cohort

was declined to 2.4:1. The Association of American Medical Colleges’ 2017 State Physician

Workforce Data Report states that 29.4% of Florida’s active physicians are female, which ranks

Florida 39th in the country; the nationwide average percentage of female physicians is 33.8%.7, 8

As shown in Figure 2, the percentage of female physicians has steadily increased from 23.1% in

2008–2009 to 29.6% in 2017–2018.

6 The 2017 Florida gender percentages are published on the United States Census Bureau’s QuickFacts webpage

(www.census.gov/quickfacts/fact/table/fl/PST045217). 7 This figure was found on pages 20 and 21 of the 2017 State Physician Workforce Data Book

(www.aamc.org/data/workforce/reports/484392/2017-state-physician-workforce-data-report.html). 8 The percentage is slightly higher than the numbers in this report, because it includes all physicians, not just those

renewing their licenses.

Female15,23329.6%

Male36,27370.4%

Figure 1: 2017-2018 Physician Gendern = 51,582

http://www.census.gov/quickfacts/fact/table/fl/PST045217

http://www.aamc.org/data/workforce/reports/484392/2017-state-physician-workforce-data-report.html


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Ethnicity

As shown in Figure 3, almost 60% of Florida’s physician workforce is White, 17.2% is Hispanic,

12.9% is Asian, and 5.4% is African American.

23.1% 23.6% 24.6% 25.4% 25.8% 26.7% 27.2% 28.2% 28.9% 29.6%

76.9% 76.4% 75.4% 74.6% 74.2% 73.3% 72.8% 71.8% 71.1% 70.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

2014-2015

2015-2016

2016-2017

2017-2018

Figure 2: Ten-Year Trend of Physicians by Gender2008-2009 to 2017-2018

Female Male

White57.5%

Hispanic17.2%

Asian12.9%

African American5.4%

Other5.1%

Native American0.1% Unspecified/Not

Provided1.8%

Figure 3: Physicians by Ethnicityn = 51,582


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The percentage of minority physicians in Florida has been increasing since reporting began in

2008 (see Figure 4).9 In the 2008–2009 cohort, minority physicians comprised 37% of all

physicians, and in the 2017–2018 cohort, minority physicians increased to 42.5%.

Florida’s population is increasing, as is the number of physicians in the state, especially minority

physicians. It is important to have a sufficient number of minority physicians, because studies

have shown that people prefer to see physicians of similar ethnicity.10 This has been attributed

to cultural and linguistic similarities creating a good patient-physician relationship. In addition, a

study in the Journal of Public Health Policy found that “patients who are of the same racial or

ethnic group as their physicians were more likely to use needed health services; were less likely

to postpone or delay seeking care; and reported a higher volume of use of health services.”11

9 The category “Other” includes those who selected Native American, Other, or did not provide an ethnicity. 10 For example, a study in the June 2010 issue of Health Services Research, pages 792–805, concluded that

“Studies on patient preferences for a same race/ethnicity physician have found that African American and Hispanic patients who have a choice are more likely to choose a same-race physician.” (www.onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2010.01086.x).

11 LaVeist, T. A., Nuru-Jeter, A., & Jones, K. E. (2003). The Association of Doctor-Patient Race Concordance with Health Services Utilization. Journal of Public Health Policy, 24(3/4), 312-323 (www.doi.org/10.2307/3343378).

57.5%

58.4%

59.1%

59.9%

60.3%

60.8%

61.3%

61.9%

62.9%

63.0%

17.2%

16.9%

16.6%

16.3%

16.0%

15.8%

15.3%

15.0%

14.6%

14.5%

12.9%

12.6%

12.5%

12.2%

11.7%

11.9%

11.9%

11.4%

10.9%

10.9%

5.4%

5.3%

5.1%

5.0%

5.0%

4.9%

4.7%

4.6%

4.4%

4.3%

7.0%

6.8%

6.7%

6.6%

7.0%

6.6%

6.8%

7.1%

7.2%

7.3%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

2017-2018

2016-2017

2015-2016

2014-2015

2013-2014

2012-2013

2011-2012

2010-2011

2009-2010

2008-2009

Figure 4: Ten-Year Trend of Physicians by Ethnicity as a Percentage of Practicing Physicians 2008-2009 to 2017-2018

White Hispanic Asian African American Other

http://www.onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2010.01086.x

http://www.doi.org/10.2307/3343378


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Since the 2008–2009 cohort, the percentage of African American physicians has increased 1.1%; the

percentage of Hispanic physicians has increased 2.7%; and the percentage of Asian physicians

has increased 2.1%. The percentage of Asian physicians exceeds the percentage in the

population, not only for Florida but for the United States as well.

Age

The average age of practicing physicians is 54. The youngest physician renewing a license was

28 years old and the oldest was 96.12 The percentage of physicians working past typical

retirement age (over 65) is 17.9%. In addition, one-third (17,208) of practicing physicians are

age 60 and older, and 26.9% (13,868) are between age 50 and 59. Figure 5 shows gender

distribution by age group, and Figure 6 shows age groups within each gender.

12 There were 41 physicians age 90 and older who renewed their license.

7.3%

14.6%

19.6%18.7%

7.9%

1.8%

6.9%

9.8%

7.7%

4.5%

1.0%0.2%

0%

5%

10%

15%

20%

Under 40 40-49 50-59 60-69 70-79 Over 80

Figure 5: 2017-2018 Physicians By Gender and Age Groupn = 50,715

Male Female


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The average age of all practicing physicians in Florida has been relatively consistent since the

2012–2013 survey cohort. In the 2012–2013 cohort, the average age was 53 years old; it

increased to 54 years old in the 2014–2015 cohort, and has not changed.

The average practicing physician age for each gender has also increased one year since 2012-

2013. In the 2012–2013 cohort, the average age for a female physician was 48 years old, and

the average age for a male physician was 55 years old. The average age for a female physician

increased to 49 years old in the 2013-2014 cohort, and the average age for a male physician

increased to 56 years old in the 2014-2015 cohort. The average age has remained constant

since then.

Approximately 49% of physicians under age 40 are female, and 51.3% are male; this

distribution is similar to the total population of Florida. The percentage of female physicians

under age 40 has increased 2.1% from 2013–2014 to 2017–2018 (see Figure 7).

23.1%

10.5%

32.5%

20.9%

25.8%

28.0%

14.9%

26.7%

3.3%

11.3%

0.4%

2.6%

0%

5%

10%

15%

20%

25%

30%

35%

Male (n = 35,482) Female (n = 15,233)

Figure 6: 2017-2018 Physicians By Age Group For Each Gender

Under 40 40-49 50-59 60-69 70-79 Over 80


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Since the 2012-2013 report, the percentage of male physicians has been decreasing and the

percentage of female physicians has been increasing in all age groups except for the 80 and

over group.

51.3%

51.2%

51.9%

52.7%

53.4%

48.7%

48.8%

48.1%

47.3%

46.6%

0% 50% 100%

2017-2018

2016-2017

2015-2016

2014-2015

2013-2014

Figure 7: Five-Year Trend of Physicians Under Age 40 by Gender

Males Females


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Physician Workforce Practice Characteristics

Primary Specialty

Figure 8 shows the distribution of physicians by 21 specialties at the physician’s primary (main

office) location.13 The top three specialty groups—internal medicine, family medicine, and

pediatrics—compose just over 50% of the total physician workforce. See Appendix C for

information regarding physician specialty by county.

Figure 8: 2017-2018 Physicians by Primary Specialty

Primary Specialty Number Percentage

Internal Medicine 14,232 28.6%

Family Medicine 7,236 14.5%

Pediatrics 3,802 7.6%

Surgery 3,153 6.3%

Emergency Medicine 3,077 6.2%

Anesthesiology 3,043 6.1%

Radiology 2,500 5.0%

Obstetrics & Gynecology 2,255 4.5%

Psychiatry 2,194 4.4%

Orthopedic Medicine 1,496 3.0%

Ophthalmology 1,270 2.6%

Neurology 1,207 2.4%

Dermatology 1,069 2.2%

Pathology 907 1.9%

Otolaryngology 646 1.3%

Physical Medicine & Rehabilitation 648 1.3%

Urology 652 1.3%

Preventive Medicine 306 0.6%

Medical Genetics 50 0.1%

Nuclear Medicine 32 0.1%

Proctology 3 0.0%

TOTAL 49,778 100% *This table does not include the 1,804 physicians who did not answer this question.

Primary care physicians are defined as those practicing in the areas of general internal

medicine, family medicine, and pediatrics.14 As shown in Figure 9, primary care physicians

make up over one-third of the active physician workforce (36.9% or 18,349). Approximately 80%

13 Due to the change in the survey platform, the choice of specialties was different, and data from the prior year were

adjusted to reflect the new options. See Appendix E for a list of specialty and subspecialty choice codes. 14 Results for general internal medicine are based on respondents who selected 2 of the 22 internal medicine

subspecialty codes (0500-0501), family medicine includes all subspecialty codes (0400–0406), and pediatrics includes all subspecialty codes (1400-1427). See Appendix E for a list of specialty and subspecialty choice codes.


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of primary care physicians specialize in internal medicine or family medicine, and approximately

21% specialize in pediatrics.

Physicians were asked about secondary and tertiary specialties at their primary (main office)

location. Just over one quarter (26.3%) of physicians reported a secondary specialty at the main

location, and 8.9% reported a tertiary specialty at their main location. A small percentage of

physicians have secondary and tertiary office locations (14.5% report a secondary location and

3.0% report a tertiary office location).

Examining the percentages of Florida’s primary care physicians from 2008–2009 to 2017–2018

shows a range of participation percentages from a low of 32.4% in the 2009–2010 cohort to a

high of 38.2% in the 2016–2017 cohort.

Only two specialties—medical specialties and surgery—have changed more than 2% from the

2008–2009 survey cohort to 2017–2018 cohort. The percentage of medical specialists

increased from 16.5% to 24.2%, and the percentage of surgery specialists has decreased from

15.9% to 6.3%.

For specialties broken out by gender, the greatest fluctuation from the 2008–2009 survey cohort

to 2017–2018 cohort for females was an almost 3.0% decrease in pediatrics; for males, the

greatest fluctuation was a 4.1% decrease in surgeons. Otherwise, specialties by gender have

been relatively stable with no more than 2% fluctuation in either direction.

Family Medicine7,23639.4%

General Internal Medicine

7,31139.8%

Pediatrics3,80220.7%

Figure 9: 2017-2018 Primary Care Physiciansn = 18,349


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Over the last five cohorts, four specialties have reported a 10% or greater intention of retiring in

the next five years—family medicine, general internal medicine, medical specialist, and surgery

(see Figure 10).

The four specialties with the highest reported percentages of physicians indicating their intention

to relocate out of state in the next five years are emergency medicine (3.9%), family medicine

(4.0%), general internal medicine (4.6%), and medical specialist (5.1%).

Practice Setting

The three practice settings where physicians are in an office encompasses almost 60% of all

physicians (see Figure 11). Of those physicians in an office practice in the 2017–2018 survey

cohort, two thirds are working in a group practice setting (67%) and 33% are working in a solo

practice setting. As shown in Figure 12, most physicians practice in an office practice setting.

Almost 45% of physicians either practice alone or with others of the same specialty. The

smallest percentages of physicians work in county health departments, nursing homes/extended

care facilities, and volunteer free clinics.

15.5% 12.8%

22.2%

10.3%

16.0%

13.4%

22.9%

9.5%

16.1% 13.8%

22.7%

9.2%

15.2%

13.9%

22.9%

9.2%

15.8%

12.7%

18.8%

11.3%

0%

5%

10%

15%

20%

25%

Family Medicine Internal Medicine -General

Medical Specialist Surgery

Figure 10: Five-Year Trend of Specialties Where Greater Than 10% of Physicians Plan to Retire in the Next 5 Years

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018


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Office Practice30,00258.2%

Hospital14,37127.9%

All Others7,20914.0%

Figure 11: 2017-2018 Percentage of Physicians by Practice Settingn = 51,582

1.9%

0.8%

1.4%

6.6%

0.5%

1.5%

0.4%

0.9%

2.1%

4.6%

5.6%

10.0%

5.6%

19.2%

25.7%

13.3%

0% 5% 10% 15% 20% 25% 30%

Did Not Answer

Volunteer Free Clinic

Urgent Care Center

Other

Nursing Home/Extended Care Facility

Federally Qualified Community Health Center

County Health Department

Ambulatory Surgery Center

Hospital–Outpatient Dept

Hospital–Other

Hospital–Hospitalist

Hospital–Hospital Based Non–Emergency

Hospital–Emergency Room

Office–Solo Practice

Office–Group Practice–Single Specialty

Office–Group Practice–Multi–Specialty

Figure 12: 2017-2018 Percentage of Physician Practice Setting by Typen=51,582


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Figure 13 shows the trends of physician practice locations since 2013 when the survey began

asking this question. In the last five survey cohorts, two of the three general practice locations

changed more than one percent; hospitalists increased 1.6% and solo office practice decreased

3.5%.

Physicians under age 40 in Florida are split almost evenly between hospital practice and office

practice, as shown in Figure 14. However, the trend seems to show a shift with the percentage

of physicians practicing in hospitals increasing and the percentage in office settings decreasing,

which mirrors national trends.15

15 Information retrieved from the article “Why Private Practice is Dying” by Reed Wilson

(http://www.forbes.com/sites/realspin/2016/09/07/why-private-practice-is-dying/#5229e3ca27c8) and The Physicians Foundation 2016 Physician Survey (http://www.physiciansfoundation.org/press-releases/the-physicians-foundation-2016-physician-survey/).

24.4%

62.9%

12.7%

25.1%

63.0%

11.9%

26.0%

62.0%

12.0%

27.2%

60.7%

12.1%

28.4%

59.3%

12.3%

0%

10%

20%

30%

40%

50%

60%

70%

Hospital Office Practice All Others

Figure 13: Five-Year Trend of the Percentage of Physicians by Practice Setting

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

40.1%

51.5%

8.4%

43.2%

49.3%

7.5%

43.3%

48.8%

7.9%

45.5% 46.6%

7.9%

46.8% 45.2%

8.0%

0%

10%

20%

30%

40%

50%

60%

Hospital Office Practice All Others

Figure 14: Five-Year Trend of Percent of Physicians by Practice Setting Under Age 40

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

http://www.forbes.com/sites/realspin/2016/09/07/why-private-practice-is-dying/#5229e3ca27c8

http://www.physiciansfoundation.org/press-releases/the-physicians-foundation-2016-physician-survey/



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Practice Hours

The workforce survey asked physicians to report the average number of patients they see per week.

As shown in Figure 15, just over 40% of physicians report seeing between 1 and 50 patients per

week, and just over 36% report seeing between 51 and 100 patients. For physicians that reported

seeing an average number of patients between one and 250, the average was 69.

As shown in Figure 16 and Figure 17, the majority of physicians reported spending between one

and nine hours on administrative matters, research, or teaching. Almost 86% of physicians

report spending less than 20 hours on administrative work, and approximately 80% spend less

than 10 hours on research and teaching.

698

20,713

18,910

7,819

828

2,614

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Zero 1–50 51–100 101–250 ≥ 251 Not Provided

Perc

en

tag

e o

f P

hysic

ian

s W

ho

See T

his

Nu

mb

er

of

Pati

en

ts

Figure 15: 2017-2018 Average Number of Patients per Week at Primary Practice Location

n=51,582

2,423

24,408

11,478

42772,253

0%

10%

20%

30%

40%

50%

60%

70%

80%

Zero 1–9 hours 10–19 hours 20–29 hours ≥ 30 hours

Figure 16: 2017-2018 Administrative Hours per Weekn = 44,839


-19-

As shown in Figure 18, most physicians spend between 40 and 59 hours per week on patient

care (41.5% or 20,611). Physicians who reported spending between one and 99 hours per week

on patient care provide an average 39.5 hours of patient care per week.

A national study that was published in 2010 showed that physician hours declined 7.2% from

1996 to 2008.16 In Florida, the workforce survey began asking about patient care hours per

week in 2013. Contrary to the national trend, the average number of patient care hours in

Florida have been consistently between 39 and 41 hours per week. During this same time

16 Staiger, D.O., Auerbach, D.I., & Buerhaus, P.I. (2010). Trends in the Work Hours of Physicians in the United

States. Journal of the American Medical Association, 303(8), 747–753. doi:10.1001/jama.2010.168 (www.jamanetwork.com/journals/jama/fullarticle/185433).

8,282

20,168

4,557

1302 799

0%

10%

20%

30%

40%

50%

60%

70%

80%

Zero 1–9 hours 10–19 hours 20–29 hours ≥ 30 hours

Figure 17: 2017-2018 Research and Teaching Hours per Weekn = 35,108

Zero0.6%

1–9 hours6.0%

10–19 hours5.7%

20–29 hours9.5%

30–39 hours19.6%

40–59 hours41.5%

60–79 hours13.8%

80–99 hours2.3%

≥1001.0%

Figure 18: 2017-2018 Average Patient Care Hours per Week at Primary Practice Location

n = 49,664

http://www.jamanetwork.com/journals/jama/fullarticle/185433


-20-

period, the average number of patients per week has slightly decreased from 72 patients per

week in 2012–2013 to 69 patients per week in 2017–2018.

Medicare Patients

In 2009, the Centers for Medicare and Medicaid Services reported that three million Floridians

were enrolled in Medicare Part A or B. According to the 2017–2018 Medicare Enrollment

Dashboard, the number of Floridians on Medicare has increased to over 4.4 million.17 Over 80%

of physicians responded that they are accepting new Medicare patients (see Figure 19).

Physicians who stated they were not accepting new Medicare patients could select the main

reason they were not. The most selected main reason they are not taking new Medicare

patients is that their practice is at full capacity, as demonstrated in Figure 20.

17 This information is published on the Centers for Medicare and Medicaid Services’ Medicare Enrollment Dashboard

on their website (www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html).

No or Not Provided9,68918.8%

Yes41,89381.2%

Figure 19: 2017-2018 Physicians Accepting New Medicare Patientsn = 51,582

Concerned About Fraud Issues3.2%

Billing Requirements19.7%

Too Much Paperwork20.3%

Low Compensation22.4%

Practice Is At Full Capacity34.4%

Figure 20: 2017-2018 Why Physicians Are Not Accepting New Medicare Patients

n = 5,022

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html


-21-

According to The Physicians Foundation’s 2016 Survey of America’s Physicians Practice

Pattern & Perspectives report, 86.3% of physicians responded that they saw Medicare patients,

which represents an almost 1% decrease from 2014 results.18 As shown in Figure 21, in Florida

the percentage of physicians accepting new Medicare patients decreased from 78% in 2008–

2009 to 70% 2009–2010. Since that time, the percentage increased to 81% in 2017-2018.

Medicaid Patients

The percentage of Florida physicians who reported accepting new Medicaid patients was 62.5%

(see Figure 22).

18 Information retrieved from The Physicians Foundation 2016 Physician Survey

(http://www.physiciansfoundation.org/press-releases/the-physicians-foundation-2016-physician-survey/).

77.7%

69.8% 71.2%

77.4% 77.6% 78.7% 78.8% 78.5% 78.3%81.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Figure 21: Ten-Year Trend of the Percentage of Physicians Accepting New Medicare Patients

No or Not Provided37.5%

Yes62.5%

Figure 22: Physicians Accepting New Medicaid Patientsn = 51,582



-22-

The most common reason given for not accepting new Medicaid patients was because of low

compensation (58.0%) (see Figure 23).

As shown in Figure 24, despite fluctuation between 2008–2009 and 2010–2011, the percentage

of physicians accepting new Medicaid patients has increased almost 10% since 2008–2009.

The average percentage of physicians accepting new Medicaid patients over this time period is

57.8%.

Concerned about Fraud Issues1.6%

Billing Requirements10.4%

Too Much Paperwork11.0%

Practice is at Full Capacity

19.0%

Low Compensation58.0%

Figure 23: 2017-2018 Why Physicians Are Not Accepting New Medicaid Patients

n = 14,152

53.6%

46.8%

66.2%

55.5% 56.0%58.4% 59.7% 59.8% 59.5%

62.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Figure 24: Ten-Year Trend of the Percentage of Physicians Accepting New Medicaid Patients


-23-

Retirement

The 2017–2018 survey responses revealed that 16.6% of practicing physicians reported that they are

planning to retire within the next five years. The average age of physicians planning to retire is 66.

Over two-thirds of the physicians planning on retiring reported that it was time to retire as the reason.

Figure 25 shows the main reasons for retirement. (Appendix D shows the counties in which these

physicians are currently located.) Of those physicians who said they would be retiring within the next

five years, almost 60% report that they are planning to change their license to a limited license in order

to volunteer.

On January 1, 2011, the Baby Boomer generation began turning 65, which is typically thought of

as retirement age.19 The percentage of physicians responding that they will retire in the next five

years has increased from 10.9% in the 2009–2010 survey cohort to 16.6% in 2017–2018, with

the last two cohorts increasing by 3% (see Figure 26). According to a Pew Research article, this

generation does not feel that they are “old” until they reach age 72, which is the milestone they

hit in 2018. Over one-third of Florida’s physicians are age 60 and older, and in that group 31.8%

(or 5,483) are age 70 or older.20

19 Information retrieved from the article “Baby Boomers Retire” by Russell Heimlich (http://www.pewresearch.org/fact-

tank/2010/12/29/baby-boomers-retire/). 20 There are 9,685 physicians who are not actively practicing in Florida that stated they plan to relocate to Florida

within the next four years; 58.8% of them are age 59 or younger. If they all move to Florida, they would exceed the number of physicians planning to retire within the next five years.

Compensation4.3%

Family4.5%

Liability Exposure3.9%

Malpractice Insurance Rates

0.7%

Medicare/Medicaid Reimbursement Rates

3.6%

Other10.8%

Private Health Plan Reimbursement Rates1.1%

Time to Retire71.0%

Figure 25: 2017-2018 Physician Retirement Reasonsn = 8,333

http://www.pewresearch.org/fact-tank/2010/12/29/baby-boomers-retire/

http://www.pewresearch.org/fact-tank/2010/12/29/baby-boomers-retire/


-24-

Relocation

In the 2017–2018 survey cohort, approximately 5% (2,676) of physicians responded that they

plan to relocate out of Florida in the next five years. As shown in Figure 27, the physicians who

said that they were relocating selected “family” as the most popular reason (28.9%).21 The

second and third most popular reasons were “compensation” (18.2%) and “looking for a

change” (17.9%).

21 An additional 40 physicians selected a reason as to why they are relocating but did not indicate they were planning

on moving to work outside of Florida in the prior question; these responses are included.

13.2%

10.9%

12.5% 13.0% 13.2% 13.4% 13.4% 13.7%

15.1%

16.6%

0%

5%

10%

15%

20%

Figure 26: Ten-Year Trend of Percentage of Physicians Who Reported They Would Retire Within Five Years

28.9%

18.2%

17.9%

17.5%

10.0%

2.5%

2.2%

1.8%

1.0%

0 100 200 300 400 500 600 700 800 900

0% 5% 10% 15% 20% 25% 30% 35%

Family

Compensation

Looking for a Change

Other

Liability Exposure



Education/Training in Another State

Private Health Plan Reimbursement Rates

Figure 27: 2017-2018 Physician Relocation Reasonsn = 2,716


-25-

In the United States, data from 2016 and 2017 show that approximately 11% of the population

moves every year. Florida is the 9th most popular state to which Americans are moving.22

However, Florida physicians reporting they are relocating has been consistent (see Figure 28),

with an average percentage of only 4.1% planning on relocating over the ten-year cohort period.

Figure 29 shows the five-year trend of physicians under age 70 who are planning on moving out

of Florida by age group. 23 For physicians under age 40, the percentage reporting that they

would relocate out of Florida has increased almost 5% from 2013–2014 to 2017–2018.

22 Information retrieved from the article “The State of the American Mover: Stats and Facts” by Colin Holmes

(https://www.move.org/moving-stats-facts/) and from a 2016 press release from the United States Census Bureau (https://www.census.gov/newsroom/press-releases/2016/cb16-189.html).

23 Physicians age 70 and older are not included because less than 5% said they are planning to relocate out of state.

4.8%

4.0% 4.1% 3.9%3.7% 3.6% 3.6% 3.6%

4.3%

5.2%

0%

1%

2%

3%

4%

5%

6%Figure 28: Ten-Year Trend of the Percentage of Florida Physicians Who Reported they Would Relocate Out of State Within Five Years

18.7

%

28.9

%

31.6

%

17.0

%

19.7

%

27.9

%

28.5

%

19.9

%

21.3

% 28.0

%

27.1

%

19.1

%

21.3

%

28.6

%

26.0

%

19.3

%

23.4

%

27.2

%

25.7

%

18.9

%

0%

10%

20%

30%

40%

Under 40 40 - 49 50 - 59 60 - 69

Figure 29: Five-Year Trend of the Percentage of Florida Physicians Who Reported they Would Relocate Out of State Within Five Years by Age Range

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

https://www.move.org/moving-stats-facts/

https://www.census.gov/newsroom/press-releases/2016/cb16-189.html


-26-

Figure 30 shows the five-year trend of those physicians under age 70 who said they were

relocating with the reason for the relocation. Family reasons, financial reasons, and “other” are

the top three reasons physicians state they will be relocating out of Florida.24

24 The financial category includes: Compensation, Malpractice Insurance Rates, Medicare/Medicaid Reimbursement

Rates, and Private Health Plan Reimbursement Rates. The reason “other” is a distinct choice and not a compilation of options. The Education/Training in Another State choice was not included in Figure 30 as the percentages were very small, with a range from 1.4% to 2.5%.

16.6%

18.1%

10.3%

25.0%

28.3%

17.6%

16.9%

11.6%

23.4%

28.1%

20.2%

15.6%

11.5%

20.4%

29.8%

20.7%

14.6%

11.9%

23.1%

27.5%

19.5%

13.3%

13.3%

26.1%

25.9%

0% 5% 10% 15% 20% 25% 30%

Other

Looking fora Change

LiabilityExposure

Financial

Family

Figure 30: Five-Year Trend of the Reasons Why Florida Physicians Under 70 Reported They Would Relocate Out of State Within the Next Five Years

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018


-27-

Changing Specialty

Unless a physician is changing from a subspecialty to the general specialty (for example,

cardiology to internal medicine), changing specialties requires a physician to complete a new

residency. Since residency programs can last from three to five years, most physicians in

Florida do not change. This explains why there were only 415 (0.8%) physicians who responded

that they plan to change their specialty. The most common reason for changing was

“Compensation” (33.7%), as illustrated in Figure 31.

Of the 415 physicians who stated they were changing their specialty, two-thirds were male and

one-third were female, as shown in Figure 32. The percentage of females changing specialty is

4.1% more than the percentage of total female physicians.

140

129

47

38

31

20

8

2

0% 5% 10% 15% 20% 25% 30% 35% 40%

Compensation

Other

Liability Exposure

Family

Education/Trainingin another state

Medicare/MedicaidReimbursement Rates

Private Health PlanReimbursement Rates

Malpractice InsuranceRates

Figure 31: 2017-2018 Physician Changing Specialty Reasonsn = 415

Female140

33.7%

Male275

66.3%

Figure 32: 2017-2018 Physicians Changing Specialty by Gendern = 415


-28-

Figure 33 shows the percentage of physicians by age group stating they are planning on

changing their specialty compared to the percentage by age group for all actively practicing

physicians. Physicians 40 to 59 years old account for just over 50% of those changing

specialties.

As shown in Figure 34, the five-year trend of physicians who reported they were changing

specialties shows a decline from 2013–2014 through 2016–2017, with an increase in 2017–

2018. However, a very small percentage of actively practicing physicians report that they plan

on changing their specialty.

21.2%

26.0%27.0%

20.0%

5.8%

0%

5%

10%

15%

20%

25%

30%

Under 40 40 - 49 50 - 59 60 - 69 70 and Older

Figure 33: 2017-2018 Physicians Changing Specialty by Age Groupn = 415

329

299276

238

415

0

50

100

150

200

250

300

350

400

450

2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

Figure 34: Five-Year Trend of Physicians Changing Specialty


-29-

Obstetrics and Gynecology Specialty Questions

There were 2,255 physicians who reported that their primary specialty was obstetrics &

gynecology (OB/GYN), of which 2,083 (or 92.4%) responded to the specialty questions.

The first specialty question was “Do you deliver babies?” As shown in Figure 35, 61.8% of those

who responded report delivering babies as part of their practice in the 2017–2018 cohort.

In the 2008–2009 cohort, just over half of OB/GYNs reported that they delivered babies. This

increased to almost three-quarters in 2011–2012 and then decreased in 2012–2013, where it

has remained at approximately two-thirds (see Figure 36).

The next specialty question was “Are you planning to discontinue obstetric care in the next two

years?” Only 14.8% plan to discontinue obstetrical care in the next two years, as shown in

Figure 37.

Not Provided102

4.9%

No694

33.3%Yes

1,28761.8%

Figure 35: 2017-2018 OB/GYNs Who Deliver Babiesn = 2,083

52.3% 56.4%70.4% 74.6% 68.8% 66.2% 66.0% 65.8% 66.3% 65.0%

47.7% 43.6%29.6% 25.4% 31.2% 33.8% 34.0% 34.2% 33.7% 35.0%

0%

25%

50%

75%

100%

Figure 36: Ten-Year Trend of OB/GYNs Who Deliver Babies

Yes No


-30-

Figure 38 shows the reasons for physicians who reported that they would be discontinuing

obstetric care within the next two years. The most cited reason was “other;” the next highest

category selected was “liability exposure” followed by “retired.” The top five reasons for

discontinuing obstetric care have been the same for the last eight survey cohorts.25

25 The 2010–2011 report was where these responses were first reported.

Yes308

14.8%

No1,42968.6%

Not Provided346

16.6%

Figure 37: 2017-2018 OB/GYNs Planning to Discontinue Obstetric Caren = 2,083

171

107

95

68

65

41

30

7

6

0

20

40

60

80

100

120

140

160

180

0% 5% 10% 15% 20% 25% 30%

Other

Liability Exposure

Retired

Medical MalpracticeLitigation

Cost of ProfessionalInsurance

GovernmentReimbursement Rates

Private Health PlanReimbursement Rates

Planning To MoveOut Of State

Do Not Maintain AFull-Time Residence In Florida

Figure 38: 2017-2018 Physicians Discontinuing Obstetric Care Reasonsn = 590


-31-

Figure 39 shows the number of obstetricians in Florida who perform cesarean sections

(C-sections) within each specified range. Of the 1,859 responses, 61.3% (1,139) responded that

they perform an average of 1-10 cesarean sections per month.

The percentage of physicians performing between 1 and 10 C-sections per month has remained

consistent over the past five cohorts, averaging just over 60%. For the last five survey cohorts,

the average percentage of physicians performing more than ten C-sections per month is less

than 10%. These results are consistent with the average number of C-sections per month per

physician, which is six. The average annual percentage of C-section births during the last ten

years is 37.7%.26, 27

Radiology Specialty Questions

There were 2,500 physicians who reported their primary specialty was radiology, of which 2,321

(92.8%) answered the specialty questions.

As shown in Figure 40, just over 40% indicate practicing in a hospital and just under a quarter

(22.9%) indicate practicing at a stand-alone imaging center.

26 This information can be found on FLHealthCharts under the health indicator of Maternal & Child Health and the

category of delivery (www.flhealthcharts.com/charts/MaternalAndChildHealth/default.aspx). 27 This calculation is based on the total number of physicians who reported they performed at least one C-Section per

month.

None582

31.3%

1–10 per month1,13961.3%

11–20 per month115

6.2%

21–30 per month20

1.1%

31 or more per month3

0.2%

Figure 39: 2017-2018 Physician C-Sections Performed per Monthn = 1,859

http://www.flhealthcharts.com/charts/MaternalAndChildHealth/default.aspx


-32-

Comparing practice settings across eight survey cohorts shows that the top three settings represent

approximately 80% of all practice settings, as presented in Figure 41.28 The top three settings are

hospital, stand-alone imaging center, and hospital-based imaging center, respectively.

28 The 2010–2011 report was where these responses were first reported.

Hospital 1,30140.7%

Stand-Alone Imaging Center

73222.9%

Hospital-based Imaging Center446

13.9%

Offsite (Internet-based) Radiology

38211.9%

Multispecialty Group Imaging Center

1855.8%

Other152

4.8%

Figure 40: 2017-2018 Radiology Practice Settingsn = 3,198 (Duplicate Count)

41.6% 40.6%41.8% 40.9% 41.0% 41.4% 41.2% 40.7%

23.3% 24.0%25.5% 25.3% 24.4% 24.1% 24.4%

22.9%

14.6% 15.0% 15.1% 15.4% 15.1% 14.1% 13.9% 13.9%

0%

10%

20%

30%

40%

50%

2010-2011 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

Figure 41: Eight-Year Trend of Top Three Radiologist Practice Locations

Hospital Stand-Alone Imaging Center Hospital-based Imaging Center


-33-

Radiologists selected each different type of patient they see, as shown in Figure 42. Almost

70% of radiologists reported that they saw general radiology patients, 42.7% of radiologists

reported seeing GI radiology patients, and 41.9% reported seeing neuroradiology patients.

As shown in Figure 43, in four of the five questions, over half of the 792 physicians who

indicated mammography as part of their practice reported that they perform the specified

procedure.

1,579

991

972

920

792

734

617

614

558

4910

200

400

600

800

1,000

1,200

1,400

1,600

1,800

0% 10% 20% 30% 40% 50% 60% 70% 80%

General Radiology

GI Radiology

Neuroradiology

GU Radiology

Mammography

Musculoskeletal Radiology

Nuclear Medicine

Pediatric Radiology

Interventional Radiology

Cardiothoracic Radiology

Figure 42: 2017-2018 Radiologic Patients by Typen = 8,268 (Duplicate Count)

32.4%

58.8%

42.4%

4.9%

4.9%

67.6%

41.2%

57.6%

95.1%

95.1%

0% 20% 40% 60% 80% 100%

Perform ultrasound & stereotacticguided core biopsies?

Read MRI guided core biopsies?

Read breast MRI's?

Read diagnostic mammogramsand sonograms?

Read screening mammograms?

Figure 43: 2017-2018 Mammography and Related Radiological Procedures

Does Not Perform This Procedure Performs This Procedure

If you indicated that mammography is part of your practice, do you:

n = 777

n = 763

n = 765

n = 768

n = 771


-34-

Physicians Not Actively Practicing in Florida

A total of 17,049 physicians are licensed but not actively practicing in Florida, representing

24.3% of the physicians who renewed their licenses in the 2017–2018 cohort.29 Understanding

the reasons why physicians did not practice in Florida in the last 12 months is useful when

considering physician attraction and retention initiatives. As shown in Figure 44, 70.2% of

physicians responded that they are “Planning to move to Florida” as the main reason why they

have a Florida license but do not practice medicine in Florida. The physicians were asked if they

planned on relocating to Florida, and 64% who answered said they plan to relocate to Florida

within four years.

29 See definition in section iii.

Planning to move to Florida10,45870.2%

Retired2,33615.7%

Liability Exposure1,0797.2%


5153.5%


2781.9%

Private Health Plan Reimbursement Rates

2381.6%

Figure 44: 2017-2018 Why Licensed Physicians Are Not Actively Practicing Medicine

n = 14,904


-35-

Figure 45 shows the specialties of the physicians who said they were planning to move to

Florida within the next 4 years. Almost one-quarter reported internal medicine as their specialty.

As shown in Figure 46, 57% of non-practicing physicians are between the ages of 50 and 69.

2,204

1,038

966

873

691

566

548

469

354

286

285

266

227

219

177

131

116

112

25

8

1

0% 5% 10% 15% 20% 25%

Internal Medicine

Anesthesiology

Family Medicine

Radiology

Surgery

Psychiatry

Emergency Medicine

Pediatrics

Obstetrics & Gynecology

Orthopedic Medicine

Pathology

Ophthalmology

Dermatology

Neurology

Physical Medicine & Rehabilitation

Otolaryngology

Urology

Preventive Medicine

Nuclear Medicine

Medical Genetics

Proctology

Figure 45: 2017-2018 Specialties of Physicians Planning to Move to Florida within the Next Four Years

n = 9,562

Under 408.3%

40-4920.4%

50-5929.1%

60-6928.1%

70-7911.5%

80 and Older2.6%

Figure 46: 2017-2018 Licensed, Non-Practicing Physicians by Age Rangen = 17,046


-36-

Department Programs to Support Physician Workforce Development

The Department administers three programs that support the physician workforce in Florida:

The State Primary Care Office, the Office of Rural Health, and the Office of Volunteer Health

Services.

The State Primary Care Office

The goals of the State Primary Care Office are to attract and retain physicians to work in Health

Professional Shortage Areas (HPSAs). Florida has 381 HPSAs: 134 are primary care, 58 are

mental health, 111 are dental, and 78 are at state correctional institutions. As of August 28,

2018, there are 569 approved National Health Service Corps (NHSC) sites, with 195 of those

sites having program participants. There are 332 participants in NHSC programs: 84 physicians

(25.3%) who participate in the NHSC loan repayment program in medically underserved areas

in Florida and 8 physicians who are NHSC Scholars. Since the inception of the State Conrad 30

Waiver Program in 1994, more than 70%, or nearly 450 physicians, continue to practice in

Florida. In addition, approximately 125 National Interest Waiver foreign physicians practice in

Florida; these physicians are required to practice in underserved areas for five years.

The Office of Rural Health

The Department’s Office of Rural Health provides statewide assistance on rural health issues

and assists in developing and sustaining systems of care in rural communities. The office

operates the National Rural Recruitment and Retention Network (3RNet) for the state of Florida.

3RNet is a national, federally supported web-based program that assists states in matching

health professionals with available practice or job opportunities in both urban and rural Health

Professional Shortage Areas (HPSAs). Facilities that utilize 3RNet include county health

departments, federally qualified health centers, rural hospitals, behavioral health centers, and

rural health clinics. While there were 7,536 hits to the website in 2017, 3RNet currently has 405

candidates and 52 active opportunities in Florida.

The Volunteer Health Care Provider Program

The Volunteer Health Care Provider Program improves access to medical care for uninsured

and underserved low-income residents by allowing licensed health care professionals to

become agents of the state. In exchange for the professional services they donate to financially

eligible clients referred by the Department’s agents and employees, participating medical

professionals are protected by state sovereign immunity. There are currently 13,872 health care

professionals serving in the Volunteer Health Care Provider Program.


-37-

Summary of 2017 Recommendations and 2018 Updates

In the 2017 Physician Workforce Annual Report, the Council recommended that the Florida

Department of Health take the following actions. Each 2017 recommendation is followed by

2018 updates.

1. Implement the changes to the Physician Licensure Survey as proposed by the Physician

Workforce Advisory Council in 2017.

2018 Update: The Department proposed several changes to the physician licensure

renewal survey based on the recommendations of the Council. The survey changes are

intended to provide more focused and specific data regarding specialty types and

practice patterns of Florida’s physician workforce. The Department conducted the rule

revision process to achieve the survey revisions.

2. Enhance collaboration with the Health Resources and Services Administration (HRSA)

through continued promotion of the National Health Service Corps Loan Repayment

Program via partnerships with the Florida Association of Community Health Centers,

rural hospital outpatient practices, federally qualified health centers, community health

centers, and the colleges of medicine.

2018 Update: The Department, through the Primary Care Office, promotes the benefits

of the National Health Service Corps by providing ongoing technical assistance to

clinicians and practice sites interested in the program. The Primary Care Office works

collaboratively with the Florida Association of Community Health Centers, the Offices of

Rural Health, and the Volunteer Health Services Program to promote the National Health

Service Corps to eligible clinics and clinicians. In addition, the Department has increased

collaboration with the Physician Workforce Advisory Council and the Council of Florida

Medical School Deans (CFMSD) to further promote the National Health Service Corps.

For example, the Department participates in the monthly CFMSD conference call in an

effort to expand collaboration.

3. Seek technical assistance from HRSA to determine action steps that will enhance

applicants’ success in being awarded loan repayment status as part of the NHSC Loan

Repayment Program.

2018 Update: The Primary Care Office provides technical assistance during each NHSC

loan repayment and site designation application cycle. The Primary Care Office works

collaboratively with the federal regional coordinators during application periods, and


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provides guidance and support to individual applicants to achieve successful site

designation and loan repayment awards. In 2017–18 in Florida, there were 17 new sites

that were National Health Service Corps designated and 65 physicians were accepted

into the Loan Repayment Program.

4. Establish and maintain a database of all physicians practicing under the visa waiver

programs in the state and monitor the long-term licensure status and practice locations

of these physicians to determine the retention of these physicians in the state’s health

professional shortage areas.

2018 Update: The Department’s Primary Care Office maintains a database of all

physicians who have participated in the Conrad 30 and National Interest Waiver

programs previously or who are currently active in the programs. Physicians practicing

under the Unites States Citizen and Immigration Services programs are required to

provide care for obligated periods of time to Florida’s medically underserved. Currently

there are 90 physicians in the Conrad 30 program and over 145 physicians in the

National Interest Waiver program who are practicing in health professional shortage

areas. The Department has determined that over 70% of physicians who have served in

these programs continue practicing medicine in Florida.

5. Identify Volunteer Health Services Program clinics that could serve as rotation sites for

medical students and primary care residents to provide experience working with

underserved populations and supplement the physician workforce in key areas of the

state.

2018 Update: The Department’s Primary Care Office has managed a legislative

appropriation to the Alachua County Organization for Rural Needs, Inc. for the past five

years. The appropriation funds the training of University of Florida health care student

clinicians, including medical students, as they participate in clinical rotations at various

free clinics in the rural areas of Alachua, Gilchrist, Putnam, and Duval counties. The

appropriation also funds the faculty supervision of these clinicians. The long-term goal of

the clinical training is to familiarize the students with the health care needs of the

medically underserved and encourage them to practice in these clinics upon graduation.

The clinics receiving funding under the management of the Alachua County Organization

for Rural Needs, Inc. are participants in the Department’s Volunteer Health Services

Program and provide valuable care to the medically underserved.


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6. Develop student diversity pipeline best practices, based on successful measures in

practice throughout the state and nation, for use as a resource by Florida medical

schools when implementing, improving, or measuring the impact of their pipeline

programs.

2018 Update: Florida’s nine medical schools have provided feedback about their

pipeline programs to the Department and the Physician Workforce Advisory Council.

Florida’s medical schools have pipeline programs which target students in elementary

school, middle school, high school, college, and at the post-graduate levels. Pipeline

program activities for students prior to college include coaching and inspiring

disadvantaged and/or minority students to go to college with skills, knowledge, and

interests in math and science. The pipeline programs for the college and graduate levels

also target disadvantaged and minority students with math and science majors to

prepare for and pursue application for entrance to medical school. Pipeline activities

include participation in community health fairs, summer programs, mentoring, shadowing

in the clinical setting, academic coaching, field trips, international medical mission trips,

and research projects. Florida’s medical schools report their pipeline programs to be

successful and essential to the goal of creating socioeconomic and gender diversity in

the physician workforce of the future.

7. Collaborate with the Council of Florida Medical School Deans to develop and maintain a

comprehensive database of current Graduate Medical Education (GME) residency

positions in Florida with the goal of describing the current and projected areas of need

that can be addressed by creating or expanding GME programs.

2018 Update: The Council of Florida Medical School Deans formed the GME Working

Group in 2016. It comprises the Associate or Senior Associate Deans for Graduate

Medical Education at the medical schools in Florida. The goal of the group is to

collaborate on GME-related issues across the state, including workforce issues,

physician wellness, research, and faculty development. As such, the GME Counting

Group was tasked with gathering and verifying the data concerning the number of

residents and fellows training in GME programs in the state. The group used a variety of

resources to count the GME trainees. The largest data set used is available on the

Accreditation Council for Graduate Medical Education (ACGME) website. Listed by

sponsoring institution and then by program, the data are a retrospective account of

trainees who have trained in the last academic year. These data are provided to the

ACGME between August and September each year. For the osteopathic medicine


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programs, data were obtained from the GME Counting Group’s members who

sponsored educational programs for the American Osteopathic Association (AOA)

sponsored programs. The group verified these numbers through website review of the

programs’ match data. Overall, Florida saw an increase of 351 GME positions between

2016–2017 and 2017–2018. The data reflect the continued growth in GME in the state,

as well as the transfer of the AOA accredited programs into the ACGME. These data

were reported to the Council of Florida Medical School Deans and provided to the State

Surgeon General. The plan is to continue with this effort, and to add the data from the

National Resident Matching Program (NRMP) regarding categorical positions in the

residency match process each year.

Figure 47: Count of GME Positions

2016–2017 Number of Positions Accreditation Council for Graduate Medical Education 5,347 American Osteopathic Association 487

TOTAL 5,834

2017–2018 Number of Positions Accreditation Council for Graduate Medical Education 5,922 American Osteopathic Association 263

TOTAL 6,185

2016–2017 vs 2017–2018 Number of Positions Accreditation Council for Graduate Medical Education +575 American Osteopathic Association -224

TOTAL +351 Source: Council of Florida Medical School Deans

8. Share the Florida Telehealth Advisory Council 2017 Report with state licensing and

regulatory boards, the Council of Florida Medical School Deans, as well as other

relevant stakeholders.

2018 Update: The Telehealth Advisory Council Report from 2017 included an analysis

of current uses of telehealth in Florida as well as recommendations for expanding the

use of telehealth to increase access to health care for more Floridians. The report was

available to stakeholders and policymakers.


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Conclusion

The Florida Department of Health renews its commitment to review and assess current and

future physician workforce needs in Florida. Physician workforce assessment and planning in

this state has resulted in new information for policymakers on clinical practice, geographic

location, and scope of practice for Florida physicians. The continuing refinement, evaluation,

and reporting of this information will assist in the state’s effort to meet current and future

physician workforce needs.

Key information from this report for policy consideration includes:

• During the last ten-year period, the number of active and practicing physicians increased

almost 37%, from 37,860 as reported in 2008–2009 to 51,582 in 2017–2018. During this

same time, the population of Florida increased almost 14%, from 18.5 million to 21.0

million

• Physicians are generally concentrated in populous counties and within large, urban

population centers. Physicians working in rural areas are more likely to be primary care

providers. Survey results indicated that 97.7% of physicians work in urban counties while

2.3% work in Florida’s 30 rural counties. See Appendix A for details.

• Gender and ethnic diversity of Florida’s physician workforce has increased since

2008–2009. The percentage of female physicians has increased from 23.1% in

2008–2009 to 29.6% in 2017–2018, and the percentage of Hispanic, Asian, African

American, and Native American physicians has increased.

• Physicians continue to specialize, with more physicians practicing in specialties than in

primary care. However, the percentage of primary care physicians in 2017–2018

(35.6%) has increased slightly from what it was in 2012–2013 (33.4%).

• Each year more physicians report that they are planning to retire. The percentage of

physicians who reported that they are planning to retire within the next five years has

increased from 13.2% in 2012–2013 to 16.6% in 2017–2018.


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Appendix A: Physician Workforce per Capita by County, 2017–2018

This map illustrates a per capita distribution of practicing physicians at the county level. Miami-Dade,

Broward, and Palm Beach Counties combined have almost one-third (32.2%) of all practicing

physicians in Florida. Miami-Dade County alone has 14.5% of all practicing physicians. Even though

these are the three most populous counties, when looking at the per capita distribution of

physicians, Alachua, Duval, Sarasota, and Escambia counties have the highest per capita rate.

Physicians Per 10,000 Population

1–10 10.1–25 25.1–50 >50


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Appendix B: Change in Practicing Physicians by County

Figure 1-B: Change in Number of Practicing Physicians by County

County 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 2017–2018

Alachua 1,324 1,370 1,426 1,443 1,429 1,615

Baker 43 42 38 37 39 46

Bay 349 380 380 395 400 424

Bradford 26 23 21 24 25 21

Brevard 1,230 1,240 1,231 1,260 1,254 1,333

Broward 4,214 4,209 4,269 4,346 4,342 4,767

Calhoun 9 9 9 8 8 11

Charlotte 367 348 338 348 332 361

Citrus 253 238 249 245 225 258

Clay 262 283 285 315 322 349

Collier 808 823 819 829 835 954

Columbia 152 136 139 144 137 142

Desoto 29 31 31 27 25 25

Dixie 8 10 12 11 15 13

Duval 2,648 2,707 2,762 2,828 2,851 3,093

Escambia 836 841 878 885 881 952

Flagler 123 121 129 139 139 150

Franklin 13 15 14 10 8 12

Gadsden 37 40 40 39 35 34

Gilchrist 7 8 8 5 7 6

Glades 6 8 7 7 8 6

Gulf 14 16 18 15 13 19

Hamilton 10 7 7 5 4 3

Hardee 16 13 13 14 12 9

Hendry 26 23 24 25 25 33

Hernando 298 300 300 313 324 334

Highlands 178 190 197 195 189 195

Hillsborough 3,363 3,356 3,470 3,611 3,696 4,041

Holmes 15 16 16 13 11 16

Indian River 360 369 371 379 370 425

Jackson 61 60 57 52 47 52

Jefferson 8 6 8 8 6 7

Lafayette 3 4 4 2 2 3

Lake 593 618 642 684 671 704

Lee 1,232 1,254 1,275 1,336 1,332 1,483

Leon 660 661 632 656 667 750

Levy 19 15 15 15 15 14

Liberty 2 0 1 2 1 2

Madison 13 10 8 9 8 9

Manatee 565 592 591 611 631 689

Marion 588 593 618 601 598 680

Martin 345 358 367 388 398 443

Miami-Dade 6,477 6,535 6,648 6,697 6,726 7,313


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County 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 2017–2018

Monroe 172 171 180 180 181 187

Nassau 85 85 83 80 76 76

Okaloosa 406 412 414 419 430 460

Okeechobee 52 57 56 49 58 61

Orange 2,707 2,808 2,844 2,977 3,079 3,473

Osceola 434 454 477 515 530 650

Palm Beach 3,654 3,710 3,804 3,919 3,901 4,262

Pasco 803 820 824 828 835 923

Pinellas 2,536 2,555 2,568 2,620 2,613 2,874

Polk 971 941 945 975 1,001 1,121

Putnam 97 107 97 84 88 98

Santa Rosa 159 174 165 172 171 193

Sarasota 1,066 1,074 1,092 1,119 1,126 1,267

Seminole 661 666 660 687 712 774

St. Johns 324 327 339 347 338 385

St. Lucie 410 414 426 428 410 447

Sumter 108 123 126 148 161 188

Suwannee 27 22 17 22 28 25

Taylor 18 16 17 20 22 18

Union 28 14 13 22 25 26

Volusia 1,002 1,015 1,051 1,049 1,040 1,140

Wakulla 7 9 10 9 8 9

Walton 68 87 91 89 89 94

Washington 21 18 19 12 10 14

State Totals 43,406 43,957 44,685 45,746 45,995 50,561


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Figure 2-B: Percentage Increase or Decrease by County

County 2012–2013

to 2013–2014

2013–2014 to

2014–2015

2014–2015 to

2015–2016

2015–2016 to

2016–2017

2016–2017 to

2017–2018

2012–2013 to

2017–2018

Alachua 3.5% 4.1% 1.2% -1.0% 13.0% 22.0%

Baker -2.3% -9.5% -2.6% 5.4% 17.9% 7.0%

Bay 8.9% 0.0% 3.9% 1.3% 6.0% 21.5%

Bradford -11.5% -8.7% 14.3% 4.2% -16.0% -19.2%

Brevard 0.8% -0.7% 2.4% -0.5% 6.3% 8.4%

Broward -0.1% 1.4% 1.8% -0.1% 9.8% 13.1%

Calhoun 0.0% 0.0% -11.1% 0.0% 37.5% 22.2%

Charlotte -5.2% -2.9% 3.0% -4.6% 8.7% -1.6%

Citrus -5.9% 4.6% -1.6% -8.2% 14.7% 2.0%

Clay 8.0% 0.7% 10.5% 2.2% 8.4% 33.2%

Collier 1.9% -0.5% 1.2% 0.7% 14.3% 18.1%

Columbia -10.5% 2.2% 3.6% -4.9% 3.6% -6.6%

Desoto 6.9% 0.0% -12.9% -7.4% 0.0% -13.8%

Dixie 25.0% 20.0% -8.3% 36.4% -13.3% 62.5%

Duval 2.2% 2.0% 2.4% 0.8% 8.5% 16.8%

Escambia 0.6% 4.4% 0.8% -0.5% 8.1% 13.9%

Flagler -1.6% 6.6% 7.8% 0.0% 7.9% 22.0%

Franklin 15.4% -6.7% -28.6% -20.0% 50.0% -7.7%

Gadsden 8.1% 0.0% -2.5% -10.3% -2.9% -8.1%

Gilchrist 14.3% 0.0% -37.5% 40.0% -14.3% -14.3%

Glades 33.3% -12.5% 0.0% 14.3% -25.0% 0.0%

Gulf 14.3% 12.5% -16.7% -13.3% 46.2% 35.7%

Hamilton -30.0% 0.0% -28.6% -20.0% -25.0% -70.0%

Hardee -18.8% 0.0% 7.7% -14.3% -25.0% -43.8%

Hendry -11.5% 4.3% 4.2% 0.0% 32.0% 26.9%

Hernando 0.7% 0.0% 4.3% 3.5% 3.1% 12.1%

Highlands 6.7% 3.7% -1.0% -3.1% 3.2% 9.6%

Hillsborough -0.2% 3.4% 4.1% 2.4% 9.3% 20.2%

Holmes 6.7% 0.0% -18.8% -15.4% 45.5% 6.7%

Indian River 2.5% 0.5% 2.2% -2.4% 14.9% 18.1%

Jackson -1.6% -5.0% -8.8% -9.6% 10.6% -14.8%

Jefferson -25.0% 33.3% 0.0% -25.0% 16.7% -12.5%

Lafayette 33.3% 0.0% -50.0% 0.0% 50.0% 0.0%

Lake 4.2% 3.9% 6.5% -1.9% 4.9% 18.7%

Lee 1.8% 1.7% 4.8% -0.3% 11.3% 20.4%

Leon 0.2% -4.4% 3.8% 1.7% 12.4% 13.6%

Levy -21.1% 0.0% 0.0% 0.0% -6.7% -26.3%

Liberty -100.0% 100.0% 100.0% -50.0% 100.0% 0.0%

Madison -23.1% -20.0% 12.5% -11.1% 12.5% -30.8%

Manatee 4.8% -0.2% 3.4% 3.3% 9.2% 21.9%

Marion 0.9% 4.2% -2.8% -0.5% 13.7% 15.6%

Martin 3.8% 2.5% 5.7% 2.6% 11.3% 28.4%

Miami-Dade 0.9% 1.7% 0.7% 0.4% 8.7% 12.9%

Monroe -0.6% 5.3% 0.0% 0.6% 3.3% 8.7%

Nassau 0.0% -2.4% -3.6% -5.0% 0.0% -10.6%


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County 2012–2013

to 2013–2014

2013–2014 to

2014–2015

2014–2015 to

2015–2016

2015–2016 to

2016–2017

2016–2017 to

2017–2018

2012–2013 to

2017–2018

Okaloosa 1.5% 0.5% 1.2% 2.6% 7.0% 13.3%

Okeechobee 9.6% -1.8% -12.5% 18.4% 5.2% 17.3%

Orange 3.7% 1.3% 4.7% 3.4% 12.8% 28.3%

Osceola 4.6% 5.1% 8.0% 2.9% 22.6% 49.8%

Palm Beach 1.5% 2.5% 3.0% -0.5% 9.3% 16.6%

Pasco 2.1% 0.5% 0.5% 0.8% 10.5% 14.9%

Pinellas 0.7% 0.5% 2.0% -0.3% 10.0% 13.3%

Polk -3.1% 0.4% 3.2% 2.7% 12.0% 15.4%

Putnam 10.3% -9.3% -13.4% 4.8% 11.4% 1.0%

Santa Rosa 9.4% -5.2% 4.2% -0.6% 12.9% 21.4%

Sarasota 0.8% 1.7% 2.5% 0.6% 12.5% 18.9%

Seminole 0.8% -0.9% 4.1% 3.6% 8.7% 17.1%

St. Johns 0.9% 3.7% 2.4% -2.6% 13.9% 18.8%

St. Lucie 1.0% 2.9% 0.5% -4.2% 9.0% 9.0%

Sumter 13.9% 2.4% 17.5% 8.8% 16.8% 74.1%

Suwannee -18.5% -22.7% 29.4% 27.3% -10.7% -7.4%

Taylor -11.1% 6.3% 17.6% 10.0% -18.2% 0.0%

Union -50.0% -7.1% 69.2% 13.6% 4.0% -7.1%

Volusia 1.3% 3.5% -0.2% -0.9% 9.6% 13.8%

Wakulla 28.6% 11.1% -10.0% -11.1% 12.5% 28.6%

Walton 27.9% 4.6% -2.2% 0.0% 5.6% 38.2%

Washington -14.3% 5.6% -36.8% -16.7% 40.0% -33.3%

Statewide 1.3% 1.7% 2.4% 0.5% 9.9% 16.5%30

30 This percentage is different from the percentage increase of all practicing physicians listed on page 4 (19%)

because 1,021 physicians in the 2017–2018 cohort did not provide a county in their survey response.


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Appendix C: Specialty Group Counts by County, 2017–2018

County

Anesthesiology (0100-0104)

Dermatology (0200-0204)

Emergency Medicine

(0300-0306)

Family Medicine

(0400-0406)

Internal Medicine

(0500-0501)

Medical Specialist31

OB/GYN (0900-0905)

Pediatrics (1400-1427)

Psychiatry (1800-1809)

Radiology (1900-1912)

Surgeons (2000-2011)

County Total

Alachua 24 21 83 175 186 469 47 145 99 97 98 1,444

Baker 1 1 3 13 6 4 0 1 14 1 1 45

Bay 6 7 32 60 57 119 19 21 18 21 36 396

Bradford 0 0 4 5 1 4 1 2 2 0 1 20

Brevard 17 30 79 194 212 392 54 73 53 72 66 1,242

Broward 73 123 296 543 716 1,326 258 357 173 233 303 4,401

Calhoun 0 0 1 6 3 0 1 0 0 0 0 11

Charlotte 5 7 23 43 53 109 7 13 19 19 29 327

Citrus 1 7 16 55 27 86 9 5 6 12 14 238

Clay 8 5 22 74 38 89 16 29 8 8 20 317

Collier 13 29 62 124 165 277 39 52 39 36 50 886

Columbia 2 1 16 23 23 32 4 9 8 6 6 130

Desoto 1 1 5 3 5 2 4 3 0 0 0 24

Dixie 0 0 1 7 1 2 0 0 1 1 0 13

Duval 48 49 225 431 360 912 141 251 94 148 188 2,847

Escambia 18 21 55 127 105 271 53 82 40 41 72 885

Flagler 1 2 11 36 18 41 5 3 2 8 8 135

Franklin 1 0 3 5 1 1 0 0 0 0 0 11

Gadsden 0 0 5 13 4 1 0 0 10 0 0 33

Gilchrist 0 0 0 3 0 0 0 2 0 0 0 5

Glades 0 0 1 3 1 0 0 0 0 1 0 6

Gulf 0 0 4 4 1 1 0 2 1 2 2 17

Hamilton 0 0 0 0 2 1 0 0 0 0 0 3

Hardee 0 0 2 3 2 0 0 2 0 0 0 9

Hendry 0 0 4 9 7 1 1 5 2 1 2 32

Hernando 6 5 28 59 68 84 11 19 16 11 20 327

Highlands 3 2 19 25 27 63 7 10 2 15 11 184

Hillsborough 62 70 222 423 611 1,171 185 293 184 201 293 3,715

Holmes 0 0 0 9 2 1 0 0 0 1 3 16

Indian River 3 12 31 50 56 131 15 21 20 25 18 382

Jackson 0 1 5 11 9 8 2 3 1 5 4 49

Jefferson 0 0 0 2 1 1 0 0 2 0 1 7

Lafayette 0 0 0 0 1 0 0 0 1 0 0 2

31 Medical Specialist includes Internal Medicine (0502-0522), Medical Genetics (0600-0605), Neurology (0700-0710), Nuclear Medicine (0800-0804), Ophthalmology (1100),

Orthopedic Medicine (1100-1103), Otolaryngology (1200-1205), Pathology (1300-1312).


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County

Anesthesiology (0100-0104)

Dermatology (0200-0204)

Emergency Medicine

(0300-0306)

Family Medicine

(0400-0406)

Internal Medicine

(0500-0501)

Medical Specialist31

OB/GYN (0900-0905)

Pediatrics (1400-1427)

Psychiatry (1800-1809)

Radiology (1900-1912)

Surgeons (2000-2011)

County Total

Lake 16 14 38 117 114 216 28 33 23 35 24 658

Lee 25 36 73 215 228 423 62 92 60 68 97 1,379

Leon 12 17 40 158 87 167 31 50 46 53 39 700

Levy 0 0 1 7 2 0 0 3 1 0 0 14

Liberty 0 0 0 1 0 1 0 0 0 0 0 2

Madison 0 0 1 4 0 2 0 0 1 1 0 9

Manatee 9 17 49 122 95 199 31 39 26 22 44 653

Marion 13 13 44 119 111 186 18 28 21 41 44 638

Martin 6 15 32 48 66 130 19 14 20 29 30 409

Miami-Dade 84 134 344 958 1,108 1,934 320 677 383 333 466 6,741

Monroe 0 4 25 30 29 43 7 7 11 6 12 174

Nassau 1 1 9 20 13 19 2 5 6 0 2 78

Okaloosa 5 7 36 72 48 109 19 25 19 33 41 414

Okeechobee 0 0 2 13 9 16 2 6 1 4 3 56

Orange 54 39 183 496 433 825 202 440 136 183 226 3,217

Osceola 7 10 61 133 88 157 31 48 22 14 41 612

Palm Beach 80 150 213 382 668 1,274 205 280 187 238 253 3,930

Pasco 18 18 59 160 169 256 30 50 42 29 48 879

Pinellas 43 64 178 443 420 803 111 229 107 132 161 2,691

Polk 18 22 81 159 190 276 50 71 44 56 63 1,030

Putnam 0 0 10 21 17 17 5 10 1 9 3 93

Santa Rosa 2 1 12 58 23 35 11 23 5 1 5 176

Sarasota 11 36 65 185 199 393 53 44 59 61 84 1,190

Seminole 11 20 46 173 97 181 38 68 33 23 49 739

St. Johns 4 8 29 95 43 88 10 26 17 17 21 358

St. Lucie 5 5 31 70 64 123 20 31 21 15 33 418

Sumter 2 11 8 52 45 42 3 3 4 12 3 185

Suwannee 0 0 5 10 3 3 0 1 2 0 0 24

Taylor 0 0 1 10 1 1 0 3 0 0 1 17

Union 0 0 1 11 2 2 0 2 4 2 0 24

Volusia 16 17 88 243 155 294 41 50 43 57 68 1,072

Wakulla 0 0 0 7 1 0 0 0 0 0 0 8

Walton 1 4 13 22 11 18 3 7 4 1 5 89

Washington 0 0 7 6 0 0 0 0 0 0 1 14

State Totals 736 1,057 3,043 7,158 7,308 13,832 2,231 3,768 2,164 2,440 3,113 46,850


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Appendix D: Physicians Planning to Retire in the Next Five Years

Of the 51,582 practicing physicians, 16.6% (8,572) said that they were planning on retiring in

the next five years. This map illustrates the percentage of practicing physicians in each county

who reported that they are planning on retiring.

Percentage of Retiring Physicians 0%

0.1%–15.0% 15.1%–25.0 % 25.1%–50.0% >50%


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Appendix E: List of Survey Specialty and Subspecialty Codes

01 Anesthesiology 0100 Anesthesiology, General 0101 Addiction Medicine 0102 Critical Care Medicine 0103 Hospice & Palliative Medicine 0104 Pain Medicine

02 Dermatology 0200 Dermatology, General 0201 Dermatological Immunology 0202 Dermatopathology 0203 MOHS Micrographic Surgery 0204 Pediatric Dermatology

03 Emergency Medicine 0300 Emergency Medicine, General 0301 Emergency Medical Services 0302 Hospice & Palliative Medicine 0303 Medical Toxicology 0304 Pediatric Emergency Medicine 0305 Sports Medicine 0306 Undersea & Hyperbaric Medicine

04 Family Medicine 0400 Family Medicine, General 0401 Addiction Medicine 0402 Adolescent Medicine 0403 Geriatric Medicine 0404 Hospice & Palliative Medicine 0405 Sleep Medicine 0406 Sports Medicine

05 Internal Medicine 0500 Internal Medicine, General 0501 Addiction Medicine 0502 Allergy & Immunology 0503 Advanced Heart Failure & Transplant Cardiology 0504 Cardiology 0505 Clinical Cardiac Electrophysiology 0506 Critical Care Medicine 0507 Endocrinology 0508 Gastroenterology 0509 Geriatric Medicine 0510 Hematology 0511 Hematology & Oncology 0512 Hospice & Palliative Medicine 0513 Infectious Disease 0514 Interventional Cardiology 0515 Oncology 0516 Nephrology 0517 Pulmonary Disease

0518 Rheumatology 0519 Sleep Medicine 0520 Sports Medicine 0521 Transplant Hepatology 0522 Undersea & Hyperbaric Medicine

06 Medical Genetics 0600 Medical Genetics, General 0601 Clinical Biochemical Genetics 0602 Clinical Cytogenetics 0603 Clinical Molecular Genetics 0604 Medical Biochemical Genetics 0605 Molecular Genetic Pathology

07 Neurology 0700 Neurology, General 0701 Addiction Medicine 0702 Clinical Neurophysiology 0703 Epilepsy 0704 Hospice & Palliative Medicine 0705 Neurodevelopmental Disabilities 0706 Neuromuscular Medicine 0707 Pain Medicine 0708 Pediatric Neurology 0709 Sleep Medicine 0710 Vascular Neurology

08 Nuclear Medicine 0800 Nuclear Medicine, General 0801 Nuclear Cardiology 0802 Nuclear Imaging & Therapy 0803 Nuclear Radiology 0804 In Vivo & In Vitro Nuclear Medicine

09 Obstetrics & Gynecology 0900 Obstetrics & Gynecology, General 0901 Critical Care Medicine 0902 Gynecologic Oncology 0903 Hospice & Palliative Medicine 0904 Maternal & Fetal Medicine 0905 Reproductive Endocrinology

10 Ophthalmology 1000 Ophthalmology, General

11 Orthopedic Medicine 1100 Orthopedic Medicine, General 1101 Hand Surgery 1102 Orthopedic Sports Medicine 1103 Orthopedic Surgery


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12 Otolaryngology 1200 Otolaryngology, General 1201 Neurotology 1202 Pediatric Otolaryngology 1203 Facial Plastic Surgery 1204 Otolaryngic Allergy 1205 Sleep Medicine

13 Pathology 1300 Pathology, General 1301 Anatomic Pathology 1302 Blood Banking & Transfusion Medicine 1303 Chemical Pathology 1304 Clinical Pathology 1305 Cytopathology 1306 Dermatopathology 1307 Hematologic Pathology 1308 Immunopathology 1309 Medical Microbiology 1310 Molecular Genetic Pathology 1311 Neuropathology 1312 Pediatric Pathology

14 Pediatrics 1400 Pediatrics, General 1401 Adolescent Medicine 1402 Child Abuse Pediatrics 1403 Developmental & Behavioral Pediatrics 1404 Hospice & Palliative Medicine 1405 Neonatal & Perinatal Medicine 1406 Neurodevelopmental Disabilities 1407 Pediatric Allergy & Immunology 1408 Pediatric Cardiology 1409 Pediatric Critical Care Medicine 1410 Pediatric Dermatology 1411 Pediatric Emergency Medicine 1412 Pediatric Endocrinology 1413 Pediatric Gastroenterology 1414 Pediatric Hematology & Oncology 1415 Pediatric Infectious Diseases 1416 Pediatric Nephrology 1417 Pediatric Neurology 1418 Pediatric Otolaryngology 1419 Pediatric Pathology 1420 Pediatric Pulmonology 1421 Pediatric Radiology 1422 Pediatric Rehabilitation Medicine 1423 Pediatric Rheumatology 1424 Pediatric Transplant Hepatology 1425 Pediatric Urology

1426 Sleep Medicine 1427 Sports Medicine

15 Physical Medicine & Rehabilitation 1500 Physical Medicine & Rehabilitation, General 1501 Hospice & Palliative Medicine 1502 Neuromuscular Medicine 1503 Pain Medicine 1504 Pediatric Rehabilitation Medicine 1505 Spinal Cord Injury Medicine 1506 Sports Medicine

16 Preventive Medicine 1600 Preventive Medicine, General 1601 Aerospace Medicine 1602 Environmental Medicine 1603 Medical Toxicology 1604 Public Health 1605 Occupational Medicine 1606 Sports Medicine 1607 Undersea & Hyperbaric Medicine

17 Proctology 1700 Proctology, General

18 Psychiatry 1800 Psychiatry, General 1801 Addiction Medicine 1802 Adolescent Psychiatry 1803 Forensic Psychiatry 1804 Geriatric Psychiatry 1805 Hospice & Palliative Care 1806 Pain Medicine 1807 Pediatric Psychiatry 1808 Psychosomatic Medicine 1809 Sleep Medicine

19 Radiology 1900 Radiology, General 1901 Body Imaging 1902 Diagnostic Radiology 1903 Diagnostic Roentgenology 1904 Diagnostic Ultrasound 1905 Hospice & Palliative Medicine 1906 Neuroradiology 1907 Nuclear Radiology 1908 Pediatric Radiology 1909 Radiation Oncology 1910 Radiation Therapy 1911 Roentgenology 1912 Vascular & Interventional Radiology


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20 Surgery 2000 Surgery, General 2001 Colon & Rectal Surgery 2002 Congenital Cardiac Surgery 2003 Hand Surgery 2004 Neurological Surgery 2005 Orthopedic Surgery 2006 Pediatric Surgery 2007 Plastic & Reconstructive Surgery 2008 Surgical Critical Care 2009 Thoracic Surgery 2010 Urological Surgery 2011 Vascular Surgery

21 Urology 2100 Urology, General 2101 Pediatric Urology

Documents

2017 Physician Workforce Annual Report€¦ · The 2018 Physician Workforce Annual Report presents a summary and analysis of the 2017 and 2018 Physician Workforce Surveys.1 Physicians